PRIMARY OVARIAN LEIOMYOMA ASSOCIATED WITH MULTIPLE UTERINE LEIOMYOMAS: A CASE REPORT

Abstract

Leiomyoma is a benign mesenchymal tumour, occurring frequently in uterus. But ovarian leiomyoma is rare, accounting less than 1% of all ovarian tumours. Ovarian leiomyoma is associated with uterine leiomyoma in about 78% of the cases. Being asymptomatic they are often incidentally detected in most of the patients. This is a case of ovarian leiomyoma associated with uterine leiomyomas in a 53 year old woman who had abdominal mass on examination during her regular check-up. Ultrasonography revealed multiple uterine fibroids and a unilocular cyst in right ovary. Total abdominal hysterectomy with bilateral salpingoophorectomy was performed. Gross examination showed left ovary totally replaced by grey-white firm mass. Microscopic features were typical of leiomyoma and was confirmed immunohistochemically. Major differential diagnostic considerations for this tumor in ovary were fibroma, thecoma and leiomyosarcoma. Though rare, ovarian leiomyoma should be considered in differential diagnosis of ovarian solid mass. The immunohistochemical staining with desmin, inhibin, and α-smooth muscle actin are useful to rule out the differential diagnosis.